Fall 2025 Research Feature

Bridging borders through social occupational therapy

Lil Crump interviews visiting Brazilian doctoral research student, Ana Carolina da Silva Almeida Prado, to discuss homelessness, substance use, and global collaboration.

When Ana Carolina da Silva Almeida Prado (Carol) began her journey as an occupational therapist in Brazil, she never imagined it would lead her across continents to Canada. Her training at the Federal University of São Carlos (UFSCar)—a place deeply rooted in social engagement and public health—instilled in her the belief that "occupational therapy is far more than a clinical practice. It is also a political, ethical, and collective endeavour aimed at addressing inequality and fostering social participation."

From her first year as an undergraduate student, Carol was involved in transdisciplinary university extension projects supporting people experiencing homelessness. She found these early encounters transformative, stating, "They taught me that occupational therapy is not only about care but also about producing knowledge and engaging critically with the social realities that shape people's lives." Working in urban contexts with vulnerable populations deepened Carol's commitment to understanding how structural factors influence daily occupations and opportunities for participation.

A research focus born from experience

Carol's doctoral research was informed by years of working with individuals experiencing homelessness in São Paulo, Brazil. "I was often struck by how public policies—though well-intentioned—failed to address the complexity of people's lived realities, particularly when substance use was involved. This led me to ask: How are these policies actually experienced by both workers and beneficiaries?" In Brazil, Carol explored these questions through participatory workshops and field observations grounded in Social Occupational Therapy—a Brazilian approach emphasizing collective, rights-based, and community-oriented practice. She observed how public policies were enacted in practice, noting their successes and shortcomings, as well as what they revealed about broader social contradictions. Here in Canada, her work expands this inquiry. "I am exploring how professionals and organizations understand and implement social and health policies addressing homelessness within local contexts. Analyzing these two realities allows me to understand how different social and political frameworks shape responses to similar challenges," explains Carol.

Coming to Canada: Learning across systems

Carol's decision to come to Canada was motivated by a desire to broaden the international dimension of her research. "Both Brazil and Canada face growing challenges related to homelessness and substance use, yet they operate within very different welfare and policy systems." Another significant influence for Carol was Professor Dr. Niki Kiepek, whose research on occupations often viewed as non-sanctioned or marginalized deeply resonated with her perspective. Dr. Kiepek's scholarship opened new ways of thinking about how human occupation interacts with social structures—a conversation Carol was eager to continue at Dalhousie University. At Dalhousie, Carol found an academic environment that values reflection, collaboration, and critical inquiry. It's a space, she says, "where Brazilian and Canadian perspectives can meet and enrich one another, advancing global discussions about occupational therapy's role in promoting social justice."

Seeing homelessness through an occupational therapy lens

Carol sees that occupational therapy offers a unique lens for examining homelessness and substance use. "It allows us to see how social and structural inequalities shape not just access to resources, but also the everyday activities that give life meaning—living, belonging, and participating in community." Using a social occupational therapy framework can connect individual experiences with collective processes. This approach helps challenge punitive responses and advocates for practices that promote autonomy, dignity, and social participation. "Throughout my research, certain moments have stayed with me," explains Carol. "I've witnessed how people experiencing homelessness create networks of solidarity in the harshest conditions, and how workers, despite limited resources, find creative ways to uphold dignity and care. These experiences demonstrate both the contradictions of the systems we operate within and the transformative potential that exists in everyday acts of resistance and compassion."

Lessons across borders

Working in both Brazil and Canada has shown Carol how deeply social values shape public responses to homelessness and substance use. In Brazil, she explains, social assistance frameworks are grounded in rights-based ideals, although they are often underfunded. In Canada, the infrastructure is stronger, but stigma and structural barriers persist. Both contexts navigate the tension between care and control.

Dr. Niki Kiepek, School Associate Professor and Supervisor, adds,"Carol's dedication to understanding structural and systems-level approaches that both perpetuate and ameliorate homelessness is an inspiration. It's an honour to have her join us at the Dalhousie School of Occupational Therapy as a visiting student, pursuing an independent program of research, supporting my research, and mentoring other students. Carol's knowledge about social occupational therapy can help us reimagine the occupational therapist role in Canada as one that promotes system-level changes and improves health equity."